Ramblings of an Emergency Physician in Texas
How on earth is it that this many people take prescription medications?
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We’re pikers compared to Korea. They have pills for every major disease and condition. When I was there a friend told me he took anti-appendicitis pills to avoid appendicitis, same for cancer, etc.
You just go to a Korean pharmacy tell the pharmacist your ills he looks at you eyes, examines your hand then gives you some concoction or other and tells you how to ingest it.
Man, ya gotta loving marketing like that
I’m not sure I see this as a problem.
Every adult in my family takes prescription meds – and, for the most part, these meds promise to let us live longer than we would without them. Our blood pressure is under control, our cancer remains in remission. This is an unambiguous good.
Some meds serve lesser goals; the Allegra that relieves me of my allergies is a personal favorite, something you cannot really appreciate until you have had the experience of sneezing 10 times in the space of a minute. I would enjoy life much less if I gave it up.
Perhaps others would be better off without this stuff. Not me!
I’m not surprised at 40%. Consider how many women are on birth control, how many of us have high blood pressure, arthritis, etc. I personally have four prescriptions, counting my oxygen which requires a prescription to get. My husband takes so many he keeps them organized in a tackle box. And neither of us has reached retirement age yet.
The longest I was on medication was you guessed it, my fertile years….birth control. Then I discovered that I tolerated an IUD really well. Asthma medication? Lots of asthmatics. Kids? Those acne meds are real popular, and let us not forget the tsunami of attitude-adjustment meds initiated by teachers.
GruntDoc, save your breath. I’m an ER doc, too, and I tried to explain to parents that little Johnny didn’t need an oral decongestant; or that if he did, the OTC ones were just fine. This line of reasoning just got me a roomful of incredulous stares, and a passel of complaint letters about how the “ER doc didn’t DO anything!”
There’s no question you’re right – patients don’t need all that junk we end up prescribing. But unfortunately, patients are now “customers” and don’t they say “the customer’s always right”??
There’s also the fact that a prescription drug in America isn’t necessarily a prescription drug elsewhere in the world. For example, Claritin was available over-the-counter in Canada nearly a decade before it went OTC in the US.
I got into this very discussion with a physician that I was working with in the ER of a small, rural hospital. He had prescribed Amoxicillin for a 10 year old child, for what he had diagnosed as a simple cold. When I asked him later why he’d prescribed something that obviously wasn’t needed, he stated, “Becuase the parents wanted a prescription.” I’m sorry, but that’s NOT a good reason.
There’s an “anti-appendicitis” pill??!
This has been the topic of conversation for me lately and it’s an interesting fact, though I almost think that it may be a little low in my experience.
Asthma drugs and insisting parents are part of the problem, as is the consumer mentality. I can think of a dozen times that I have been called out emergency to a house for a child with a cold and have the parents demand that the kid be transported so that they can get an antibiotic. Of course this opens up a whole can of worms on it’s own. I can also think of a few times that I have been called to schools for a child that is having an “asthma attack” who presents with clear breath sounds, High O2 sats and is seemingly in the throes of a “dramatic arrest”.
Another possible cause, the endless stream of drug companies taking to the air waves with their ads. I was out at Taco Mac last night and was watching the different NFL games on different TVs, and one after another after another there was a string of drug ads. Then of course, Email. With all the masculine enhancement products sitting for me in my inbox, I almost think that there is an ex out there spreading some dirty rumors.
Top it off with a prevailing sense of entitlement, and a medicaid card, and you have a spiraling trend where everyone has a right to all the pills they can eat and in the end, someone else will pay for it… It’s a bad recipe.
What is the answer? I don’t know. I read a book where a psych doc pulled an entire town off their meds and secretly placed them on placebos… a tempting thought, but if the book is right, there is a sea monster waiting for us when it happens. Tough love? Maybe, but I have patients who know which doc is working at which ER on certain nights and dictate their destination accordingly. If you tell them No, then I’ll get called out the next night to take them to County Hospital instead of General.
It’s a difficult question.
You can be young, firm and sexually active until you are a hundred if you give up Carbs and replace it with a coctail of meds… If you get Herpes, you can mask it. If you lack stimulant in certain areas, you take a blue pill and you become stimulated. If you become too stimulated in other areas, you can take other pills to bring you back down…
Difficult questions and difficult answers. The pills are easy, they can make anything go away… but what do you do to make the needless pills go away?
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